URGENT: Still within 72 hours after exposure deep scratch with the nail that was in vaginaAug 9, 2010

Dear Doc Bob,

I've sent this question yesterday. Just to be sure that you get it in your email box I'm sending it again. Sorry for possible spam...

I've oral and vaginal sex with condom with sex worker (HIV status unknown). At some point my erection decreased and she switched to oral stimulation, then made a couple of laps with her hand and then decide to continue hand job without condom. So she touch the condom that was inside her pussy (followed by couple minutes of oral sex straight forward with the same condom) with her hands then removed it and continued with her hand. Another possible risk comes from the fact that I've found afterwards scratch around 3 cm next to my knee, that was deep enough to have really a bit of blood out. I don't know exactly when (Im sure I have gotten it during this session), neither if it was done by me or her. She masturbated her pussy without protection. So in the worst case I've gotten the scratch from nail that was inside her pussy (at least with 4-5 minutes delay).
1. How would you estimate the risk?
2. What should I do now (about 60 hours after exposure)?
3. Would you recommend PEP?
4. Are other STDs possible?

Thanks a lot for thousands of emails that you are answering every day. Donatation is in process.

Victor

Response from Dr. Frascino

Hello Victor,

1. Exceedingly low.

2. I'd suggest you ratchet down your level of anxiety over this incident. I would recommend a single HIV test at the three-month mark.

3. Nope.

4. Possible, but unlikely. Your doctor can easily screen you for common STDs if you are worried.

Thanks for your support of The Robert James Frascino AIDS Foundation (www.concertedeffort.org). In return I'm sending my good-luck karma that your definitive three-month test is negative.

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